Latinos are disproportionately represented in the US HIV epidemic. Despite being a population at high risk for an HIV infection, approximately half of Latinos in the US have never been tested for HIV. Over half of new HIV infections among US Latinos are among Spanish-speaking immigrants, which indicates a need for innovative, effective, culturally-sensitive, and linguistically-appropriate approaches to conduct HIV screening and diagnostic testing. Such approaches also must be effective for those with lower health literacy skills. In this R21 study, Video-based delivery of HIV test information for Spanish-speaking Latinos, we will build upon our prior success in developing an effective informational video for English-speaking HIV test recipients. Our goal in this project is to produce a video that enables Spanish-speaking Latinos, particularly those with lower health literacy skills, to comprehend fundamental information about HIV and HIV testing. The video will ultimately be employed to help streamline and encourage HIV screening and diagnostic testing efforts. This R21 early-stage, formative research will proceed in three successive stages. In Stage I, we will obtain input about how to culturally and linguistically adapt the original English-language HIV and HIV test information video from a national sample of 60 English- and Spanish-speaking Latino HIV test recipients and 15 English- and Spanish-speaking Latino HIV test providers from the healthcare and the community outreach HIV testing settings. In Stage II, we will produce the Spanish-language video using this input and conduct cognitive-based assessments of the video among a national sample of 60 Spanish-speaking Latino HIV test recipients and 15 Spanish-speaking Latino HIV test providers from the healthcare and the community outreach HIV testing settings. During Stage I and II, we will seek input from a demographically diverse group of respondents from various Latino sub-cultures, as well as those who have lower health literacy skills. In Stage III, we will conduct a randomized, controlled, non-inferiority trial evaluating the effectiveness of the Spanish-language HIV and HIV test information video among Spanish-speaking HIV test recipients in the healthcare and the community outreach HIV testing settings. We aim to determine if HIV test recipients who watch the Spanish-language video have a similar level of knowledge about HIV and HIV testing as those who receive identical in-person information through a presentation from an HIV test counselor. We are specifically interested in whether the video is as or even more effective for those with lower health literacy skills. If the video is shown to be effective, we will make the Spanish-language video freely available for any non- commercial use to groups that are conducting HIV screening and diagnostic testing. We plan to use the video for a future RO1(s) on improving delivery of HIV and HIV test information for those with lower health literacy skills, streamlining HIV test efforts, and increasing utilization of HIV testing among Latino populations. PUBLIC HEALTH RELEVANCE: Latinos, particularly native Spanish-speakers, are overrepresented in the HIV epidemic in the US, and only half of US Latinos have ever been tested for HIV. The video produced from this research will provide a culturally-sensitive and linguistically-appropriate means of facilitating HIV screening and diagnostic testing for Spanish-speaking Latinos. The ultimate aim of this project is to help reduce the transmission of HIV through streamlined yet effective HIV testing approaches.